B.C’s 220 registered midwives have issued notice that they will unilaterally terminate their agreement with the government in 90 days.

The Midwives Association of B.C. hopes to negotiate a deal that increase both the number of practising midwives and their wages before their deadline of Oct. 7, but have immediately stopped taking students studying in the field for practical work placements, said Ganga Jolicoeur, the association’s executive director.

The department of family practice at the University of British Columbia offers a four-year bachelor of midwifery and recently doubled the number of student spaces from 10 to 20.

“It would significantly compromise the program if that action were sustained,” says Jolicoeur.

At issue is a plan the association presented to the Ministry of Health earlier this year which asks for a funding increase of $3 million per year over five years. While the proposal includes a 15-per-cent pay raise for midwives over five years, 85 per cent of the spending would go toward making it easier for pregnant women to find a midwife near them, particularly in rural areas and First Nations’ communities, she said.

“We feel very confident that what we brought to the table is not just serving the interests of midwives. It’s answering the growing maternity care gap in this province,” said Jolicoeur. “We’re at a place where we know that this is a crisis. We have part of the solution and we need to be heard.”

Women who are already consulting a midwife will be able to continue until after their babies are delivered, even if the dispute is not resolved by October, said Kristy Anderson, manager of media relations for the Ministry of Health.

“If you are currently receiving care from a midwife, you will continue to receive care until six weeks postpartum,” she said in a telephone interview.

Possible job action after Oct. 7 could include not accepting new patients.

“Stopping delivering babies is not on the table,” says Jolicoeur. “Midwives consider that an essential service.”

Recent contract agreements between the province and public service unions have limited wage increases of 5.5 per cent over five years, Anderson noted.

The midwives association predicts a shortfall in care for expectant mothers and new babies as family doctors and specialists continue to retire from smaller centres throughout the province, with few replacements in sight.

For midwives who are already on the job outside of Metro Vancouver, some haven’t turned their pager off in years because there is no one to replace them, Jolicoeur says. That’s why she’s asking the province to expand a $300,000 pilot program that pays midwives to temporarily cover vacationing colleagues.

In a written statement, Anderson said the ministry is disappointed by the action and would not further discuss negotiations publicly. She noted the previous agreement with the association spent $1.9 million over two years to expand midwifery services and $130,000 to help midwives who want to set up practices in rural communities.

“The ministry is supportive of the role midwives play in a woman’s pregnancy, labour and delivery, and postpartum care. Ideally, women would give birth as close to their family and community as possible — no matter where they live in the province.”

Midwives have been licensed in B.C. since 1998 and their services are covered under the province’s Medical Service Plan. Jolicoeur says a midwife earns about $3,000 from a typical client seen from conception to six weeks after delivery. From that, she will have to pay for travel, insurance and other expenses.

The Midwives Association of B.C. also created a video ‘bellygram’ addressed to Premier Christy Clark that uses the stomachs of pregnant women as a canvas for their message. The video can be viewed at: http://ow.ly/zt9U2

Birthing baby, by the numbers:

The Midwives Association of British Columbia released a vision document in early 2014 outlining the reasons why it says 35 per cent of all births in this province should be assisted by its members by 2020. Statistics in the report include:

220: Number of registered midwives practicing in B.C. in 2012/13

7,360: Number of midwife-assisted births in B.C. in 2012/13

16: Percentage of midwife-assisted births in 2012/13

70: Percentage of births in B.C. considered low-risk, therefore candidates of midwife services

17: Percentage of midwife-assisted births that are planned home births

83: Percentage of midwife-assisted births that occur in hospitals

18 hours: Average reduction in hospital stay duration after a midwife-assisted birth

42 per cent: Fewer births by caesarean section in midwife-assisted births than provincial average